Health care in the crosshairs

Health care services for the poor and uninsured could face drastic cuts if legislators refuse to raise new revenues to cope with Louisiana’s massive mid-year budget gap. The Department of Health and Hospitals said it would have to cut $131 million over the last five months of the fiscal year – and much more if lawmakers refuse to tap the state’s “rainy day” fund,  redirect oil spill settlement money and make across-the-board cuts. The AP’s Melinda Deslatte reports that DHH laid out two options for dealing with the potential cuts.

Nearly all the cuts would be levied on the privatized LSU hospitals that care for the poor and uninsured, under the first scenario. With lost federal matching dollars, the reduction would reach $315 million, a 24 percent cut to spending on the hospital contracts, but with less than half a year to spread out the hit. Under the other proposal, all optional Medicaid programs would be eliminated. That would include getting rid of hospice services for terminally ill patients and ending a program that provides health care services to more than 600 “medically fragile” children. A wide array of home- and community-based programs that serve the elderly and people with developmental disabilities would be shuttered. Stricter limits also would be placed on prescription drugs for Medicaid patients under the second scenario. “The reality is both plans will have a catastrophic impact to those served by Medicaid,” Health and Hospitals Secretary Rebekah Gee said in a statement…”If this reduction plan becomes a reality, its impact will be felt by almost all residents,” she said.

HBCUs struggling to fulfill mission
Louisiana’s historically black colleges and universities have been particularly hard hit by the budget cuts of the past eight years. As The Advocate’s Andrew Vanacore reports in the latest installment of the newspaper’s eight-part series on higher education, that’s because fewer students at HBCU’s are buffeted by TOPS scholarships.

This is where Louisiana’s budget cuts have landed hardest the past eight years: on the shoulders of students who would have been struggling to pay for college anyway. And the suffering is most acute at Southern and the state’s other historically black schools. At Southern, tuition and fees have climbed almost 90 percent since 2008 to make up for the loss of direct aid from the state. Where tuition used to account for just over a third of the school’s budget, it’s now almost two-thirds. Students across town at predominantly white LSU are coping with similar increases in tuition and fees, but more than half of them receive merit-based scholarships from the state’s Taylor Opportunity Program for Students, shielding both students and the institution they attend from the worst of the budget cuts. At Southern and the state’s other predominantly black schools, only a tiny fraction of students qualify for TOPS scholarships. The result is that universities founded to offer a historically disenfranchised minority an escape from poverty are struggling more and more to fulfill their mission in Louisiana. Faculty members are fleeing. Graduation rates remain low. Enrollment has declined, and the number of black students attending four-year schools in Louisiana is shrinking. (The numbers of black students at two-year colleges has grown, meanwhile.)

Budget gaps don’t stop raises
The budget crisis that Louisiana is struggling with didn’t stop former Gov. Bobby Jindal and some statewide elected officials from handing out $8 million in pay raises this budget year. The The Associated Press estimates that number will grow to $15 million next year when annualized. Once again, Melinda Deslatte has the story:

Commissioner of Administration Jay Dardenne said the pay hikes granted by the Jindal administration “on their way out the door” were irresponsible. Of statewide elected officials who gave raises, Dardenne called that “disappointing.” The state is grappling with a more than $700 million budget gap this year and estimates of a $1.9 billion shortfall in the fiscal year that begins July 1. Under civil service guidelines, state workers are eligible to receive a “performance adjustment” up to 4 percent a year if they receive a positive annual job evaluation. Many state departments withheld those raises this year, deciding they couldn’t afford them.

Secretary of State Tom Schedler and Commissioner of Insurance Jim Donelon defended their decisions:

Secretary of State Tom Schedler said employee performance merited the increases as his agency cut staff in recent years amid budget cuts, asking workers to pick up more duties.

“I’m constantly fighting losing people to much higher-paying jobs in the private sector,” Schedler said. “I felt that in order to keep some vital employees around here and for morale, it was imperative that I do something.”

Insurance Commissioner Jim Donelon, who gave raises to 175 of his employees, said he had little choice, because he couldn’t sign a civil service form attesting he didn’t have enough money. But Donelon said that wasn’t his only reason for granting $171,000 in raises this year. “I don’t want to hide behind that. I think my staff is deserving … I think they are very hard working and dedicated,” Donelon said.”

Public defenders see lawsuit as an opportunity

The American Civil Liberties Union is suing the public defender’s office in New Orleans for its refusal to take on any more felony defense cases due to understaffing and overwhelming caseloads. Both organizations, which typically work together to protect the constitutional rights of their clients, see the lawsuit as an opportunity to force the Legislature to increase funding. Eli Hager of the Marshall Project has more.

The public defender’s office in New Orleans says it is so understaffed and overwhelmed that it can no longer fulfill its Constitutional mission: to provide legal representation to the city’s poor. So it has refused to take most new felony cases. Since 2012, the office’s budget has been slashed from $9.5 million to $6 million, including $700,000 in new cuts this year. With no money to pay additional staff, caseloads have become so onerous that the lawyers can spend only seven minutes preparing for each of their cases.

“We don’t necessarily welcome being sued,” says Derwyn Bunton, New Orleans’ chief public defender, “and I can’t pretend to know the ACLU’s strategy. But we’re approaching this lawsuit as an opportunity.” How that plays out in the legislature is unclear. Eric LaFleur, the chairman of the Louisiana Senate’s finance committee, is in charge of vetting next year’s budget. He says that the public defenders “have certainly got our attention,” because some “bad guys will go unprosecuted if they don’t have a lawyer.” But the likelihood of more funding for indigent defense, he says, remains slim. “They can draw attention to their plight, but the basic fiscal situation remains the same: With the budget deficit we have, people who commit crimes are still a low priority.”

 
Number of the Day
90 – Percentage increase in fees and tuition at Southern University since 2008, which has made up for lost aid from the state. (Source: The Advocate)